Metabolic syndrome: A patient-related prognostic factor for cancer?

Abstract

Sir, We read with interest the article recently published by Caliskan et al.[1] The authors prospectively assessed the effect of metabolic syndrome (MetS) on prostate cancer final pathology of 117 patients. A significant increased prostate-specific antigen level and a higher prevalence of advanced disease were observed among prostate cancer individuals with MetS. In this regard, we would like to discuss and complement these findings, in special to comment on the impact of MetS on prognostic factor of different tumors. The global worldwide prevalence of obesity and other noncommunicable diseases is increasing dramatically. Obesity is the major determinant of MetS, defined as a cluster of risk factors for heart disease, stroke, and diabetes mellitus. It includes increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels. In a large systematic review and meta-analysis, the presence of MetS was strongly associated with increased risk of some cancers. The results of studies differ according to ethnicity and gender.[2] However, epidemiological studies on the association between MetS and cancer prognosis and outcome have been relatively scarce. We conducted an electronic search for articles about the effect of MetS on the prognosis of different types of cancer. We selected three studies that evaluated MetS and its impact on breast, colorectal, and general cancers.[345] We have found strong evidence of the association between MetS and cancer outcomes [Table 1].Table 1: The effect of myelodysplastic syndrome on cancer prognosis and outcomeIn addition, in a prospective study performed by our group, 91 sequential myelodysplastic syndrome (MDS) patients were evaluated. MDS is a heterogeneous group of hematologic cancer characterized by ineffective hematopoiesis that leads to peripheral blood cytopenias and an increased risk of evolution to acute myeloid leukemia and mainly affects the older population. The mean age of MDS patients was 71.6 years ± 11.4 (38–96). MetS was diagnosed in 41.8% (n = 38) of patients. There were a significant association between MetS and older patients (≥65 years) (P = 0.04) and a significant association between MetS and transfusion dependency (DT) (P = 0.04). DT is an important and severe prognostic factor for MDS and other hematologic diseases. No significant association was observed between other hematologic markers (hemoglobin, neutrophil count, platelets, and bone marrow blast percentage). Beyond classic disease-related prognostic factors, comorbidities and other patient-related prognostic factors are well known to negatively impact outcomes. Chronic pathologies, as MetS, have become an important leading cause of nondisease-related death among this population. It is highly recommended that all cancer patients have a careful general assessment at the time of diagnosis and during the course of the disease and that prevention measures are implemented. Financial support and sponsorship This study was conducted with partial support from the National Council for Scientific and Technological Development and the Brazilian Company of Hospital Services. Conflicts of interest There are no conflicts of interest.